Masking tinnitus -- a condition often perceived as ringing in the ears -- with sound therapy devices won't make the problem disappear, researchers found.

Action Points

Explain that masking tinnitus -- a condition often perceived as ringing in the ears -- with sound therapy devices won't make the problem disappear, according to a review of published studies.

Note that there were no side effects or significant morbidity associated with the use of sound therapy devices.

Masking tinnitus -- a condition often perceived as ringing in the ears -- with sound therapy devices won't make the problem disappear, researchers found.

A review of the literature uncovered no evidence that use of devices that emit sounds such as "white noise" to "mask" the tinnitus is effective, Jonathan Hobson, MD, of Royal Preston Hospital in England, and colleagues reported in the Cochrane Review.

"There is no evidence from the available literature that a significant change in loudness of tinnitus or the overall severity of tinnitus can be achieved following the use of sound-generating devices as a sole intervention," Hobson and co-authors wrote.

Tinnitus is the perception of sound without actual external acoustic stimulation.

According to the American Speech, Language, and Hearing Association (ASHA), one third of all adults experience tinnitus at some time in their lives. For some people, the condition can be chronic and cause psychological problems, including anxiety and insomnia; about 10% to 15% of adults have prolonged tinnitus requiring medical evaluation, according to ASHA.

Sound therapy for tinnitus is delivered via specific devices worn in the ear, an MP3 player, or an under-the-pillow speaker for nighttime use. Researchers believe that playing alternative sounds -- including noises akin to static called white noise -- may balance out the sounds perceived by tinnitus patients that can include ringing or whooshing noises, Hobson and colleagues wrote.

To assess the effectiveness of sound therapy for the management of tinnitus among adults, the researchers conducted a review of the literature, ultimately including six studies encompassing a total of 553 patients.

The primary outcomes were change in the loudness or severity of tinnitus, and the impact of the sound therapy device on quality of life.

Overall, they found no evidence of the treatment's efficacy.

One study showed that users subjectively found the sound therapy devices more helpful and reported lower levels of tinnitus annoyance with their use -- but there was no significant difference between sound therapy devices, hearing aids, or combination devices.

Another study showed that using the devices for six months lowered scores on the Tinnitus Handicap Questionnaire, but this was less than the effect seen for tinnitus retraining therapy, which involves counseling.

Across the board the researchers found that retraining therapy appeared more efficacious.

Hobson and colleagues noted, however, that tinnitus retraining therapy protocols often include noise generators as an essential element of the rehabilitation process. In fact, many studies have looked at this combination therapy, which makes it challenging to extract the benefits that are due solely to sound therapy.

They also noted that there were no long-term data, making it impossible to assess whether the effect of sound therapy is maintained after its initial use.

Overall, there were no side effects or significant morbidity associated with the use of sound therapy devices, and the researchers cautioned that the "absence of conclusive evidence should not be interpreted as evidence of a lack of effectiveness."

They called for future research focusing on providing a consensus as to the most appropriate outcome measures for tinnitus -- since there's currently a lack of standardized outcome assessments. In fact, there were more than 10 different outcome instruments among the studies included in this review.

There's also a need for longer-term follow up of patients, they added.

They concluded that the limited data failed to show strong evidence of the efficacy of sound therapy in tinnitus management, and that other forms of therapy, including retraining therapy, have been assessed in other reviews.

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